Ang A K, Brown O W
J Vasc Surg. 1986 Dec;4(6):563-6.
Anticoagulation is the cornerstone in the treatment of deep vein thrombosis. However, the treatment of septic deep vein thrombosis is controversial. Unlike septic superficial vein thrombosis, venous excision is often associated with limb-threatening or even life-threatening complications. Some authors have suggested thrombectomy as the only means of resolving the sepsis. We reviewed our experience with seven patients who had septic deep vein thrombosis. Phlebography or noninvasive studies documented deep vein thrombosis and blood cultures were positive in all patients. The mean age was 31.5 years with a male/female ratio of 5:2. All patients were treated with anticoagulants and intravenous antibiotics. One patient required surgical exploration for associated abscess of the groin. The patients became afebrile with normal white blood cell counts from 3 to 18 days after therapy was begun. No cases of recurrent sepsis occurred. We conclude that antibiotic therapy and anticoagulation are adequate treatment and therefore consider venous thrombectomy unnecessary.
抗凝治疗是深静脉血栓形成治疗的基石。然而，感染性深静脉血栓形成的治疗存在争议。与感染性浅静脉血栓形成不同，静脉切除术常伴有威胁肢体甚至危及生命的并发症。一些作者建议将血栓切除术作为解决脓毒症的唯一手段。我们回顾了7例感染性深静脉血栓形成患者的治疗经验。静脉造影或非侵入性检查证实所有患者均存在深静脉血栓形成且血培养均为阳性。平均年龄为31.5岁，男女比例为5:2。所有患者均接受了抗凝剂和静脉抗生素治疗。1例患者因腹股沟相关脓肿需要进行手术探查。治疗开始后3至18天，患者体温恢复正常，白细胞计数正常。未发生复发性脓毒症病例。我们得出结论，抗生素治疗和抗凝治疗是充分的治疗方法，因此认为静脉血栓切除术没有必要。
